Influencing factors and predictive indicators of vascular calcification

doi:10.3969/j.issn.1004-583X.2022.02.003

Abstract

Abstract:

Objective To analyze the predictive factors of vascular calcification, and to explore its effective prediction indicators.Methods A retrospective analysis was performed in totally 467 vascular calcification patients admitted to the Department of Vascular Surgery, the First Hospital of Hebei Medical University from August 2018 to July 2020. Those patients were registered into case group and control group as whether with or without vascular calcification, and the clinical data were collected. Univariate and multivariate Logistic regression analysis were used to explore influencing factors of vascular calcification. Receiver operating characteristic (ROC) curve was drawn to analyze predictive value.Results In 467 cases, there were 191 cases (40.9%, 191/467) with vascular calcification. The independent factors for predicting vascular calcification were albumin/fibrinogen ratio(OR=0.725, 95%CI 0.630-0.834, P<0.01), fibrinogen degradation product (OR=1.626, 95%CI 1.086-2.433, P=0.018), lipoprotein (OR=1.003, 95%CI 1.002-1.004, P<0.01), high density lipoprotein-cholesterol (OR=0.101, 95%CI 0.016-0.630, P=0.014), total cholesterol (OR=4.009, 95%CI 1.619-9.926, P<0.01), low density lipoprotein-cholesterol (OR=0.148, 95%CI 0.042-0.517, P<0.01), and the area under the curve (AUC) related the above parameters were 0.828, 0.780, 0.720, 0.679, 0.570, and 0.563, respectively.Conclusion The independent predictors for vascular calcification were albumin/fibrinogen ratio, fibrinogen degradation product, lipoprotein, high density lipoprotein-cholesterol, total cholesterol, low density lipoprotein-cholesterol, of which, albumin/fibrinogen ratio, fibrinogen degradation product and lipoprotein is better capable of predicting vascular calcification, and albumin/fibrinogen ratio has top advantageous value.

Key words: vascular calcification, albumin/fibrinogen ratio, risk factors, ROC curve

CLC Number:

R561.2

Zheng Lihua, Du Runsen, Zhao Yaheng, Liu Peng. Influencing factors and predictive indicators of vascular calcification[J]. Clinical Focus, 2022, 37(2): 114-118.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.02.003

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I2/114

Figures/Tables 4

References 27

[1]	Smith ER, Hewitson TD, Holt SG. Diagnostic tests for vascular calcification[J]. Adv Chronic Kidney Dis, 2019,26(6):445-463. doi: 10.1053/j.ackd.2019.07.001 URL
[2]	Shao JS, Sierra OL, Cohen R, et al. Vascular calcification and aortic fibrosis: A bifunctional role for osteopontin in diabetic arteriosclerosis[J]. Arterioscler Thromb Vasc Biol, 2011,31(8):1821-1833. doi: 10.1161/ATVBAHA.111.230011 URL
[3]	Zazzeroni L, Faggioli G, Pasquinelli G. Mechanisms of arterial calcification: The role of matrix vesicles[J]. Eur J Vasc Endovasc Surg, 2018,55(3):425-432. doi: 10.1016/j.ejvs.2017.12.009 URL
[4]	Youssef G, Guo M, McClelland RL, et al. Risk factors for the development and progression of thoracic aorta calcification: The multi-ethnic study of atherosclerosis[J]. Acad Radiol, 2015,22(12):1536-1545. doi: 10.1016/j.acra.2015.08.017 pmid: 26403646
[5]	Yang W, Zou B, Hou Y, et al. Extracellular vesicles in vascular calcification[J]. Clin Chim Acta, 2019,499:118-122. doi: 10.1016/j.cca.2019.09.002 URL
[6]	Vossen LM, Kroon AA, Schurgers LJ, et al. Pharmacological and nutritional modulation of vascular calcification[J]. Nutrients, 2019,12(1):100. doi: 10.3390/nu12010100 URL
[7]	López-Mejías R, González-Gay MA. IL-6: Linking chronic inflammation and vascular calcification[J]. Nat Rev Rheumatol, 2019,15(8):457-459. doi: 10.1038/s41584-019-0259-x pmid: 31235835
[8]	Sun DW, An L, Lv GY. Albumin-fibrinogen ratio and fibrinogen-prealbumin ratio as promising prognostic markers for cancers: An updated meta-analysis[J]. World J Surg Oncol, 2020,18(1):9. doi: 10.1186/s12957-020-1786-2 URL
[9]	Demer LL, Tintut Y. Inflammatory, metabolic, and genetic mechanisms of vascular calcification[J]. Arterioscler Thromb Vasc Biol, 2014,34(4):715-723. doi: 10.1161/ATVBAHA.113.302070 URL
[10]	Leopold JA. Vascular calcification: Mechanisms of vascular smooth muscle cell calcification[J]. Trends Cardiovasc Med, 2015,25(4):267-274. doi: 10.1016/j.tcm.2014.10.021 URL
[11]	Raggi P, Bellasi A, Bushinsky D, et al. Slowing progression of cardiovascular calcification with SNF472 in patients on hemodialysis: Results of a randomized phase 2b study[J]. Circulation, 2020,141(9):728-739. doi: 10.1161/CIRCULATIONAHA.119.044195 URL
[12]	Akers EJ, Nicholls SJ, Di Bartolo BA. Plaque calcification: Do lipoproteins have a role?[J]. Arterioscler Thromb Vasc Biol, 2019,39(10):1902-1910. doi: 10.1161/ATVBAHA.119.311574 pmid: 31462089
[13]	Sánchez-Duffhues G, García de Vinuesa A, van de Pol V, et al. Inflammation induces endothelial-to-mesenchymal transition and promotes vascular calcification through downregulation of BMPR2[J]. J Pathol, 2019,247(3):333-346. doi: 10.1002/path.2019.247.issue-3 URL
[14]	Arefin S, Buchanan S, Hobson S, et al. Nrf2 in early vascular ageing: Calcification, senescence and therapy[J]. Clin Chim Acta, 2020,505:108-118. doi: 10.1016/j.cca.2020.02.026 URL
[15]	Lee SJ, Lee IK, Jeon JH. Vascular calcification-New insights into its mechanism[J]. Int J Mol Sci, 2020,21(8):2685. doi: 10.3390/ijms21082685 URL
[16]	Naito M. Effects of fibrinogen, fibrin and their degradation products on the behaviour of vascular smooth muscle cells[J]. Nihon Ronen Igakkai Zasshi, 2000,37(6):458-463. doi: 10.3143/geriatrics.37.458 URL
[17]	Yakovlev S, Zhang L, Ugarova T, et al. Interaction of fibrin(ogen) with leukocyte receptor alpha M beta 2 (Mac-1): Further characterization and identification of a novel binding region within the central domain of the fibrinogen gamma-module[J]. Biochemistry, 2005,44(2):617-626. pmid: 15641787
[18]	Fiuza M. Lipoprotein(a) as a novel therapeutic target for preventing cardiovascular disease:A whiter shade of pale?[J]. Rev Port Cardiol, 2019,38(7):495-496. doi: 10.1016/j.repc.2019.08.006 URL
[19]	Arques S. Human serum albumin in cardiovascular diseases[J]. Eur J Intern Med, 2018,52:8-12. doi: 10.1016/j.ejim.2018.04.014 URL
[20]	Choi SR, Lee YK, Cho AJ, et al. Malnutrition, inflammation, progression of vascular calcification and survival: Inter-relationships in hemodialysis patients[J]. PLoS One, 2019,14(5):e0216415. doi: 10.1371/journal.pone.0216415 URL
[21]	Liu SL, Wu NQ, Shi HW, et al. Fibrinogen is associated with glucose metabolism and cardiovascular outcomes in patients with coronary artery disease[J]. Cardiovasc Diabetol, 2020,19(1):36. doi: 10.1186/s12933-020-01012-9 URL
[22]	Dellegrottaglie S, Saran R, Rajagopalan S. Vascular calcification in patients with renal failure: Culprit or innocent bystander[J]. Cardiol Clin, 2005,23(3):373-384. pmid: 16084285
[23]	Lia SQ, Jianga YH, Lin J, et al. Albumin-to- fibrinogen ratio as a promising biomarker to predict clinical outcome of non-small cell lung cancer individuals[J]. Cancer Med, 2018,7(4):1221-1231. doi: 10.1002/cam4.2018.7.issue-4 URL
[24]	Tsujino T, Komura K, Hashimoto T, et al. C-reactive protein-albumin ratio as prognostic factor in renal cell carcinoma-A data from multi-institutional study in Japan[J]. Urol Oncol, 2019,37(11):812.e1-812.e8. doi: 10.1016/j.urolonc.2019.04.002 URL
[25]	Özdemir M, Yurtdaᶊ M, Asoğlu R, et al. Fibrinogen to albumin ratio as a powerful predictor of the exaggerated morning blood pressure surge in newly diagnosed treatment-naive hypertensive patients[J]. Clin Exp Hypertens, 2020,42(8):692-699. doi: 10.1080/10641963.2020.1779282 URL
[26]	Afifi NM, Medhat B, Abdel Ghani AM, et al. Value of albumin-fibrinogen ratio and CRP-albumin ratio as predictor marker of disease activity in egyptian RA patients, correlated with musculoskeletal sonography[J]. Open Access Rheumatol, 2020,12:241-248.
[27]	Kayapinar O, Ozde C, Kaya A. Relationship between the reciprocal change in inflammation-related biomarkers (fibrinogen-to-albumin and hs-CRP-to-albumin ratios) and the presence and severity of coronary slow flow[J]. Clin Appl Thromb Hemost, 2019,25:1076029619835383.

项目	对照组(n=276)	病例组(n=191)	统计值	P值
性别(例)
男女	169 107	127 64	χ²=1.346	0.246
年龄(岁)	65.884±11.540	68.377±9.693	t=1.172	0.241
身高(cm)	169.673±28.235	167.037±14.870	t=0.117	0.459
体重(kg)	74.223±11.818	67.862±10.535	t=0.568	0.136
中性粒细胞占比(%)	0.604±0.087	0.679±0.108	t=0.763	<0.01
淋巴细胞占比(%)	0.303±0.080	0.226±0.094	t=0.877	<0.01
纤维蛋白原(g/L)	2.881±0.908	3.748±1.005	t=0.906	<0.01
FDP(mg/L)	0.780±1.008	6.215±35.884	t=0.214	<0.01
甘油三酯(mmol/L)	1.530±1.165	1.504±1.299	t=0.021	0.439
HDL-C(mmol/L)	1.123±0.329	0.968±0.243	t=0.536	<0.01
LDL-C(mmol/L)	2.856±0.683	2.705±0.758	t=0.211	<0.05
脂蛋白(mg/L)	205.057±243.927	391.962±301.786	t=0.681	<0.01
GGT(U/L)	26.663±21.357	34.395±41.667	t=0.234	<0.01
hs-CRP(mg/L)	2.221±4.752	26.826±54.662	t=0.634	<0.01
白蛋白(g/L)	41.364±3.609	36.864±5.376	t=0.983	<0.01
AFR	14.979±3.020	10.682±3.528	t=1.308	<0.01
总胆固醇(mmol/L)	4.586±0.930	4.355±1.116	t=0.224	<0.05

项目	对照组(n=276)	病例组(n=191)	统计值	P值
性别(例)
男女	169 107	127 64	χ²=1.346	0.246
年龄(岁)	65.884±11.540	68.377±9.693	t=1.172	0.241
身高(cm)	169.673±28.235	167.037±14.870	t=0.117	0.459
体重(kg)	74.223±11.818	67.862±10.535	t=0.568	0.136
中性粒细胞占比(%)	0.604±0.087	0.679±0.108	t=0.763	<0.01
淋巴细胞占比(%)	0.303±0.080	0.226±0.094	t=0.877	<0.01
纤维蛋白原(g/L)	2.881±0.908	3.748±1.005	t=0.906	<0.01
FDP(mg/L)	0.780±1.008	6.215±35.884	t=0.214	<0.01
甘油三酯(mmol/L)	1.530±1.165	1.504±1.299	t=0.021	0.439
HDL-C(mmol/L)	1.123±0.329	0.968±0.243	t=0.536	<0.01
LDL-C(mmol/L)	2.856±0.683	2.705±0.758	t=0.211	<0.05
脂蛋白(mg/L)	205.057±243.927	391.962±301.786	t=0.681	<0.01
GGT(U/L)	26.663±21.357	34.395±41.667	t=0.234	<0.01
hs-CRP(mg/L)	2.221±4.752	26.826±54.662	t=0.634	<0.01
白蛋白(g/L)	41.364±3.609	36.864±5.376	t=0.983	<0.01
AFR	14.979±3.020	10.682±3.528	t=1.308	<0.01
总胆固醇(mmol/L)	4.586±0.930	4.355±1.116	t=0.224	<0.05

项目	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
项目	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
中性粒细胞占比	1.118	11.828	0.009	<0.01	3 187.985	356.281	28 525.934
淋巴细胞占比	-0.849	6.035	0.020	<0.01	0.000	0.000	0.000
纤维蛋白原	0.936	6.731	0.019	0.063	3.719	2.727	5.072
FDP	0.569	0.431	1.743	<0.01	2.379	1.846	3.065
总胆固醇	1.001	0.342	8.567	0.020	0.797	0.659	0.965
HDL-C	-1.932	0.971	3.960	<0.01	0.074	0.030	0.182
LDL-C	-1.609	0.546	8.684	0.030	0.741	0.566	0.971
脂蛋白	0.063	0.001	3 969	<0.01	1.003	1.002	1.004
GGT	0.203	0.012	286.179	0.018	1.010	1.002	1.018
hs-CRP	0.026	0.023	1.277	<0.01	1.170	1.109	1.234
AFR	-0.622	0.723	0.739	<0.01	0.654	0.600	0.711
白蛋白	0.782	2.134	0.134	0.132	0.779	0.736	0.825

项目	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
项目	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
中性粒细胞占比	1.118	11.828	0.009	<0.01	3 187.985	356.281	28 525.934
淋巴细胞占比	-0.849	6.035	0.020	<0.01	0.000	0.000	0.000
纤维蛋白原	0.936	6.731	0.019	0.063	3.719	2.727	5.072
FDP	0.569	0.431	1.743	<0.01	2.379	1.846	3.065
总胆固醇	1.001	0.342	8.567	0.020	0.797	0.659	0.965
HDL-C	-1.932	0.971	3.960	<0.01	0.074	0.030	0.182
LDL-C	-1.609	0.546	8.684	0.030	0.741	0.566	0.971
脂蛋白	0.063	0.001	3 969	<0.01	1.003	1.002	1.004
GGT	0.203	0.012	286.179	0.018	1.010	1.002	1.018
hs-CRP	0.026	0.023	1.277	<0.01	1.170	1.109	1.234
AFR	-0.622	0.723	0.739	<0.01	0.654	0.600	0.711
白蛋白	0.782	2.134	0.134	0.132	0.779	0.736	0.825

项目	回归系数	标准误	Wald χ²值	P值	OR值	95%CI
项目	回归系数	标准误	Wald χ²值	P值	OR值	下限	上限
中性粒细胞占比	1.228	6.243	0.039	0.844	3.413	0.000	703 933.786
淋巴细胞占比	-0.549	6.943	0.007	0.937	0.577	0.000	469 265.822
FDP	0.486	0.206	5.565	0.018	1.626	1.086	2.433
总胆固醇	1.388	0.462	9.013	0.003	4.009	1.619	9.926
HDL-C	-2.293	0.935	6.013	0.014	0.101	0.016	0.630
LDL-C	-1.909	0.638	8.953	0.003	0.148	0.042	0.517
脂蛋白	0.003	0.001	9.000	<0.01	1.003	1.002	1.004
GGT	0.003	0.006	0.250	0.596	1.003	0.992	1.014
hs-CRP	0.026	0.014	3.500	0.065	1.026	0.998	1.054
AFR	-0.322	0.072	19.800	<0.01	0.725	0.630	0.834